Similar revision rate after cemented and cementless femoral revisions for periprosthetic femoral fractures in total hip arthroplasty: analysis of 1,879 revision hip arthroplasties in the Dutch Arthroplasty Register

Abstract

Background and purpose: Periprosthetic femoral fracture (PPF) after total hip arthroplasty (THA) is a serious complication, as it often is followed by functional deficits and morbidity. There is no consensus regarding the optimal stem fixation method and whether additional cup replacement is beneficial. The aim of our study was to perform a direct comparison of reasons and risk of re-revision between cemented and uncemented revision THAs following PPF using registry data.Patients and methods: 1,879 patients registered in the Dutch Arthroplasty Registry (LROI) who underwent a first-time revision for PPF between 2007 and 2021 (cemented stem: n = 555; uncemented stem: n = 1,324) were included. Competing risk survival analysis and multivariable Cox proportional hazard analyses were performed.Results: 5- and 10-year crude cumulative incidence of re-revision following revision for PPF was similar between cemented (resp. 13%, 95% CI 10–16 and 18%, CI 13–24) and uncemented (resp. 11%, CI 10–13 and 13%, CI 11–16) revisions. Multivariable Cox regression analysis, adjusting for potential confounders, showed a similar risk of revision for uncemented and cemented revision stems. Finally, we found no difference in risk of re-revision between a total revision (HR 1.2, 0.6–2.1) compared with a stem revision.Conclusion: We found no difference in the risk of re-revision between cemented and uncemented revision stems after revision for PPF.

Early Postoperative Functional Recovery in Older Patients With Periprosthetic Femoral Fractures: Comparison Between Cemented and Cementless Stem Revisions

“…However, few reports have compared the results of revision using cemented and cementless stems for UCS type B2 PFFs. Although there is one study in which the primary outcome was mid-term postoperative survivorship [ 11 ], no studies have compared the 2 surgical procedures in terms of early postoperative functional recovery. Reports suggest that hip arthroplasty with cemented stems offers advantages, including improved early loading tolerance and pain reduction, compared to cementless stems [ 12 ].…”